Response to and toxicity of gemcitabine for recurrent ovarian cancer according to number of previous chemotherapy regimens

Takei, Yuji; Takahashi, Yoshifumi; Machida, Shuichi; Taneichi, Akiyo; Takahashi, Suzuyo; Nagashima, Tomomi; Morisawa, Hiroyuki; Saga, Yasushi; Matsubara, Shigeki; Fujiwara, Hiroyuki

doi:10.1111/jog.13203

Cited by 7 publications

(10 citation statements)

References 19 publications

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“…The conventional chemotherapeutic drugs used in these clinical trials include the platinum‐based chemotherapeutic drugs (e.g., cisplatin and oxaliplatin), gemcitabine, and docetaxel. These drugs can cause severe side effects during therapy such as nephrotoxicity caused by cisplatin and a high prevalence of haematopoiesis suppression by gemcitabine (Manohar & Leung, ; Takei et al, ). Although some of the clinical trials were complete, none of the results was reported in detail (Table ).…”

Section: Introductionmentioning

confidence: 99%

Natural compounds as potential adjuvants to cancer therapy: Preclinical evidence

Lin

Hsu

Tsai

et al. 2019

British J Pharmacology

289

175

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Traditional chemotherapy is being considered due to hindrances caused by systemic toxicity. Currently, the administration of multiple chemotherapeutic drugs with different biochemical/molecular targets, known as combination chemotherapy, has attained numerous benefits like efficacy enhancement and amelioration of adverse effects that has been broadly applied to various cancer types. Additionally, seeking natural‐based alternatives with less toxicity has become more important. Experimental evidence suggests that herbal extracts such as Solanum nigrum and Claviceps purpurea and isolated herbal compounds (e.g., curcumin, resveratrol, and matairesinol) combined with antitumoral drugs have the potential to attenuate resistance against cancer therapy and to exert chemoprotective actions. Plant products are not free of risks: Herb adverse effects, including herb–drug interactions, should be carefully considered. Linked Articles This article is part of a themed section on The Pharmacology of Nutraceuticals. To view the other articles in this section visit http://onlinelibrary.wiley.com/doi/10.1111/bph.v177.6/issuetoc

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Section: Introductionmentioning

confidence: 99%

Natural compounds as potential adjuvants to cancer therapy: Preclinical evidence

Lin

Hsu

Tsai

et al. 2019

British J Pharmacology

289

175

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“…Options include treatment with a recurrence regimen that does not contain platinum or supportive-palliative care. Several recurrence agents show similar effect as single regimen: topotecan, 20% [ 4 ]; gemcitabine, 19% [ 7 ]; vinorelbine, 20% [ 28 ]; liposomal doxorubicin, 26% [ 8 ]; oral etoposide, 27% [ 9 ]; and ifosfamide, 12% [ 10 ]. Ifosfamide is the classical group of alkylating chemotherapeutic agent, that produces renal toxicity [ 15 ], but toxicity could be overcome using mesna for uroprotection and massive hydration.…”

Section: Discussionmentioning

confidence: 99%

“…However, the management of tumor recurrence remains a clinical challenge, since in the platinum-resistant (recurrence less than 6 months) population the chance of response to a secondary treatment is currently less than 20% [ 3 ]. Several single chemotherapeutic agents have been used in this setting and have demonstrated modest activity such as topotecan [ 4 5 ], gemcitabine [ 6 7 ], liposomal doxorubicin [ 8 ], oral etoposide [ 9 ], and ifosfamide [ 10 ]. It cannot be overemphasized the importance of clinical trials to identify agents active in this group of resistant patients.…”

Section: Introductionmentioning

confidence: 99%

Retrospective study of combination chemotherapy with etoposide and ifosfamide in patients with heavily pretreated recurrent or persistent epithelial ovarian cancer

et al. 2018

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ObjectiveThis retrospective study is to evaluate the efficacy and toxicity of combination chemotherapy with etoposide and ifosfamide (ETI) in the management of pretreated recurrent or persistent epithelial ovarian cancer (EOC).MethodsPatients with recurrent or persistent EOC who had measurable disease and at least one chemotherapy regimen were to receive etoposide at a dose of 100 mg/m2/day intravenous (IV) on days 1 to 3 in combination with ifosfamide 1 g/m2/day IV on days 1 to 5, every 21 days.ResultsFrom August 2008 to August 2016, 66 patients were treated with ETI regimen. Most patients were heavily pretreated prior to ETI: 53 (80.3%) patients had received 3 or more chemotherapy regimens. The response rate (RR) of ETI chemotherapy was 18.2% and median duration of response was 6.8 months (range, 0–30). Median survival of all patients was 5 months at a median follow up of 7.2 months. Platinum-free interval (PFI) more than 6 months prior to ETI has statistically significant correlation with overall survival (OS; 9.2 vs. 5.6 months; P=0.029) and RR (34.5% vs. 5.4%; P<0.010). However, treatment free interval before ETI, number of prior chemotherapy regimen, and optimality of primary surgery did not show significant difference for RR or OS. Grade 3 or 4 hematologic toxicities were observed in 7 cases (3%) of the 232 cycles of ETI.ConclusionThe ETI combination regimen shows comparatively low toxicity and modest activity in heavily pretreated recurrent or persistent EOC patients with more than 6 months of PFI after last platinum treatment.

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“…The following items were compared between PLD therapy and GEM therapy: the number of previous chemotherapy regimens, response rate, DCR and relative dose intensity. For GEM therapy, we previously reported data 13 . In brief, GEM at 1000 mg/m 2 was administered for 30 min on Days 1, 8 and 15 of each 28‐day cycle.…”

Section: Methodsmentioning

confidence: 99%

“…We previously investigated the efficacy and safety of GEM therapy with reference to the number of previous chemotherapy regimens, and reported that although adverse events did not increase with an increased number of previous regimens, the disease control rate (DCR) slightly decreased 13 . The purpose of the present study was to investigate the efficacy and toxicity of PLD as chemotherapy for platinum‐resistant recurrent ovarian cancer in relation to the number of previous chemotherapy regimens, and to compare the results with those of GEM therapy.…”

Section: Introductionmentioning

confidence: 99%

Efficacy and toxicity of pegylated liposomal doxorubicin as therapy for recurrent ovarian cancer in relation to the number of previous chemotherapy regimens: Comparison with gemcitabine

Takahashi

Takei

Machida

et al. 2020

J of Obstet and Gynaecol

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Aim Pegylated liposomal doxorubicin (PLD) is one of the second‐line chemotherapy regimens for platinum‐resistant recurrent ovarian cancer, but in clinical practice, it is also used for third or subsequent lines of chemotherapy. There is no report on the efficacy and toxicity of PLD in relation to the number of previous chemotherapy regimens. The purpose of this study was to clarify these points and compare with the results of gemcitabine (GEM) therapy we reported previously. Methods We retrospectively reviewed the medical records of patients with platinum‐resistant recurrent ovarian cancer who underwent two or more cycles of PLD therapy between July 2009 and March 2017 at our institution. We used our reported data of GEM for comparison analysis. Results Seventy‐eight patients were enrolled in this study. The overall response rate was 19.2% and the disease control rate (DCR) was 53.8%. The DCR with 1, 2, 3, and 4 or more previous regimens was 53.8%, 48.6%, 63.6% and 66.7%, respectively. Grade 3/4 neutropenia and anemia developed in 59.0% and 12.8%, respectively. Grade 2 or higher hand ‐foot syndrome, stomatitis, and liver dysfunction developed in 25.6%, 25.6% and 2.6%, respectively. When the number of previous regimens was 3 or higher, the DCR of PLD was significantly higher than that of GEM (64.7% vs 30.8%, P = 0.037). Conclusion The DCR did not decrease with a greater number of previous regimens. When the number of previous regimens was 3 or higher, PLD therapy had a superior DCR to GEM therapy. Toxicity was tolerable in PLD therapy.

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Response to and toxicity of gemcitabine for recurrent ovarian cancer according to number of previous chemotherapy regimens

Abstract: Although DCR decreased as the number of previous chemotherapy regimens increased, the toxicities did not increase. Gemcitabine may be relatively safe in heavily pretreated ovarian cancer patients.

Cited by 7 publications

References 19 publications

Natural compounds as potential adjuvants to cancer therapy: Preclinical evidence

Natural compounds as potential adjuvants to cancer therapy: Preclinical evidence

Retrospective study of combination chemotherapy with etoposide and ifosfamide in patients with heavily pretreated recurrent or persistent epithelial ovarian cancer

Efficacy and toxicity of pegylated liposomal doxorubicin as therapy for recurrent ovarian cancer in relation to the number of previous chemotherapy regimens: Comparison with gemcitabine

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